Friday, 31 October 2014

Making ‘Make in India’ a reality

Devendra Kothari PhD
Population and Development Analyst
Forum for Population Action

India’s large unwanted fertility, a threat to ‘Make in India’ initiative, demands immediate attention.

During U.S. trip, Prime Minister Narendra Modi’s important outreach was to American business. This was part of his "Make in India" drive, which he lunched in a high-profile event a day before he embarked on his U.S. trip. He wrote in the Wall Street Journal: “Make in India is our commitment — and an invitation to all — to turn India into a new global manufacturing hub. We will do what it takes to make it a reality.” Also, it was a message occupying front and centre when he met both Japan's Shinzo Abe and China's Xi Jinping. India’s prime minister is known for his pro-business policies, and his steady efforts to draw foreign investments could plant the seeds for a more prosperous India.

But there are some major problems standing in the way of making India an attractive investor destination that can not be solved overnight.  There is a long list of infrastructure problems: patchy electricity, lack of roads, inadequate port facilities. Further, cumbersome labor regulations are among the biggest hurdles to setting up manufacturing in India, which fell to 134th place this year in a World Bank index of countries for doing business. Moreover, land for factories is often impossible to acquire at any price. Another problem is that India’s labor force is skewed toward the agriculture sector, even though its highest groth industries like information technology, telecom, healthcare, and retail are projected to require millions of new skilled workers which they may not be able to find due to poor quality of education. There is another major problem that is red tapism and the culture of babugiri that it has engendered.[1]

In short, India is ranked as one of the worst countries of the world in which to do business. PM Modi is already in the process to create investor friendly environment.  “For the success of ‘Make in India,’ ease of doing business should be given priority,” said PM Modi, while inaugurating ‘Shramev Jayate Karyakram'. He announced labor reforms at this occasion, simplifying employment rules and aiming to give a lift to manufacturing and job creation. At the same time, he announced a program for skills development, in which the Labor Ministry will finance the first two years of training for apprentices in manufacturing units. Also, since he took office in May, Modi has begun to execute on the systematic reformation of India’s inefficient and bureaucratic markets to make them friendlier and more open for investors and businesses. Lots of other measures are under active consideration; and things will be much clearer by next budget. I believe GST will be in place by then, some labor reforms will take place and some important pressing issues like environmental clearance and land acquisition bill will be sorted out as soon as possible.

No doubt, such relatively straightforward steps could make a powerful difference, raising the Indian growth rate by two or even three percentage points from its current 4-5% but not create sustainable environment for ‘Make in India’ to succeed. The Modi government could be wrong in simply believing that the big investments by the American, Chinese and Japanese among others will solve all the problems of India. Some experts are saying that ‘make in India’ is more of hype than substance.

The economic liberalization in India started in 1991 of the country's economic policies, with goal of making the economy more market-oriented and expanding the role of the private and foreign investment. As a result, a decade ago India’s economy was winning new-found respect as a riot of energy and enterprise, but its performance in recent years has been dismal. Now foreign bosses roll their eyes when you mention India, as they did in the 1980s. Growth has fallen to 5%, half the level at the peak of the 2004-08 boom. Inflation and public borrowing are too high. The rupee slumped all the time low in 2013. Private firms are fed up with red tape and graft and have cut investment from a peak of 17% of GDP to 9%. On some measures the country is going backwards in time. In a country that should be industrializing, the contribution to GDP from industry has been declining while manufacturing jobs have stagnated. 

Now question arises: Why India could not reap the fruits of economic liberalization? There may be several reasons behind this sorry state of affairs, but I think that efforts made over the last two decades to improve the economy have mainly been neutralized by the rapid growth of population. The economic reforms completed 20 years in July, 2011, however, during this period, India’s population increased by 365 million, much more than the total population of USA - the third most populous country in the world; and it is still growing by around 17 to 18 million every year.  One has to recognize that population is an important factor in sustainable development, especially when it is growing seemingly out of control since it leads to a significant diversion of national investable resources to consumption which could otherwise be used for increasing investment and productivity and for improving the quality of public services such as education, health, sanitation, provision of safe drinking water, etc

With 1.27 billion people and still growing, India is getting dangerously overcrowded. India is currently the second most populous nation in the world. It will surpass China as the most populous within 5-7 years. India's population is projected to peak at 1.7 billion in 2060. China at its peak in 2025 will have 1.4 billion people. In fact, when China peaks, India will have already surpassed it in population. Many Indians including policy makers see these emerging demographics as a critical advantage in competition with the nation it regards   as its chief rival – China.  Another popularly held belief by India’s policy makers and experts is that as a country becomes economically more prosperous, its fertility declines significantly and leads to a stable population. However, this is a simplistic view of a complex phenomenon.[2] 

Current population growth is mainly fuelled by unwanted fertility. More than four in ten pregnancies are unintended/unplanned or simply unwanted by the women who experience them and half or more of these pregnancies result in births that spur continued population growth.  More than  26 million children are born in India every year and out of this about 6 million births have been classified as unplanned/unintended or simply  unwanted. Based on findings of the National Family Health Surveys 1, 2 and 3, it is estimated that currently there are around 460 million people out of 1270 million in India who are product of unwanted pregnancies, and most of them are from the lower economic strata. [3]  The consequences of unwanted pregnancy are serious, slowing down the process of socio-economic development. It is because unwanted childbearing results in poor physical growth, reduced school performance, diminished   concentration in daily tasks thus impacting work capacity and work output resulting in diminished earning capacity. The impact of unwanted childbearing is reflected in widespread hunger, poverty, unemployment as well as increasing scarcity of basic resources like food, water and space in several parts of India despite concerted developmental efforts since 1991.

There may be several reasons behind unwanted childbearing, but most important one is related to the imperfect control over the reproductive process. While India’s population continues to grow by 17-18 million annually, 15 million  married  women, mostly from  Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh , seek to postpone childbearing, space births, or stop having children, but are not using modern contraception. Often, these women travel far from their communities to reach a health facility, only to return home “empty handed” due to shortages, stock outs, lack of options, and/or non availability of doctors and paramedical staff.  So letting women have the means to manage their childbearing will help to make India a more stable, equal and vibrant place. When women have access to contraception appropriate to their needs, desires, and budgets, the potential benefits are many, including reduced maternal and child mortality as well as lesser number of abortions and unwanted pregnancies. In addition to its health benefits, family planning allows families and communities to invest more in education and health care and helps reduce poverty, as argued by the President of Population Council, Peter J. Donaldson.

Here, children by choice not by chance are the only way poor can aspire a better life and good health. For this, direct efforts aimed at decreasing the rate of natural increase of population should be intensified through greater access to suitable voluntary reproductive health services, information, and education and of acceptable methods of family regulations ( see:  Kothari, Devendra and Sudha Tewari. 2009. “Slowing Population Growth in India: Challenges, Opportunities and the Way Forward”. MIPD Policy Brief No.2, Management Institute of Population and Development, a unit of Parivar Seva Sanstha, New Delhi.). Also, fertility reduction efforts, beyond family planning, should become an integral part of the planning for human development, and should aim at improving quality of life of the family and the status of women.[4]

Food for thought: 
Over the past half century most East Asian countries have prospered by focusing on the reproductive health including population stabilization and education (Table 1). The replacement level fertility of 2.1 children per woman, required to initiate the process of population stabilization, has already been achieved by Thailand (1.5), China (1.6), Brazil (1.7) and even Islamic country Iran (1.9), as shown in Table 1.  Indonesia, another Muslim dominating country is going to attain it within couple of years; However, India will not achieve this level before 2035, as per the UN Population Division. In the last forty years, the total fertility in China declined from 6 children per woman in 1970 to 1.6 in 2010, whereas the rate of decline was much slow in India in the corresponding period (Table 1).[5] On an average, a woman in India produces 2.7 children during her lifetime and more than thirty percent of it could be classified as unwanted fertility.[6] The replacement level fertility of 2.1 children per woman, required to initiate the process of population stabilization, has already been achieved by Thailand (1.5), China (1.6), Brazil (1.7) and even Islamic country Iran (1.9), as shown in Table 1.  Indonesia, another Muslim dominating country is going to attain it within couple of years; However, India will not achieve this level before 2035, as per the UN Population Division.

Table 1: Trends in total fertility, infant mortality and literacy rates, selected countries.
Country
Number of children per woman (TFR)*
Infant deaths per 1000 births (IMR)*
% literates (age 15 and over  who can read and write)**

1970
2010
1970
2010
2012
1
2
3
4
5
6
India
5.7
2.7
132
51
61
Brazil
5.4
1.7
100
24
89
china
6.0
1.6
163
18
92
Indonesia
5.6
2.2
118
29
90
Iran
6.7
1.9
154
21
87
Mexico
6.8
2.3
80
17
86
Thailand
6.0
1.5
76
12
93
Source: *World Population Prospects: The 2012 Revision and **CIA World Fact book.

The most important change in the world over the past 40 years has been the rise of China. The increase in its average annual GDP per head from around $300 to $6,750 over the period has not just brought previously unimagined prosperity to hundreds of millions of people, but has also remade the world economy and geopolitics. India’s GDP per head was the same as China’s four decades ago. It is now less than a quarter of the size. Despite a couple of bouts of reform and spurts of growth, India’s economy has never achieved the momentum that has dragged China out of poverty. The human cost, in terms of frustrated, underemployed, ill-educated, unhealthy, hungry people, has been immense. In fact, PM Modi is interested in copying China’s development agenda.   He came to power promising manufacturing jobs, high-speed trains and ‘smart’ cities. Hope India will learn from the East Asian countries, especially China that the reduced population growth rate and quality of education helps in achieving sustainable and faster development.    

The country stands on the threshold of becoming a powerful regional, if not world, power. For this to happen, India's politicians will need the political gumption to initiate a bold population policy. Now, for the first time ever, India has a strong government whose priority is growth and at the same time most of the people including Muslims do not want more children (See article by the author - Growing Population in India and Islam: Some Facts - at http://kotharionindia.blogspot.in/2011/09/growing-population-in-india-and-islam.html).  The Modi government’s most important immediate task is to initiate the process of population stabilization by providing services in un-served and underserved areas by realigning the capacity of health system to deliver quality care to suit the needs of clients. This would bring economic as well as governance benefits. A radical revamps of family planning program is the only way to do justice to the politics of aspiration that is ‘Make in India’.





[1]See: Jug Suraiya, Red tape carpet: For ‘Make in India’ to succeed, Modi needs to end babugiri at http://blogs.timesofindia.indiatimes.com/jugglebandhi/red-tape-carpet/ 

[2] Kothari, Devendra and S.  Krishnaswamy. 2003. “Poverty, Family Planning and Fertility vis-a vis Management of Family Planning Services in India: A Case Study” in Maria Eugenia COSIO-ZAVALA (ed.) Poverty, Fertility and Family Planning. Paris: CICRED, pp. 335-58.

[3] Kothari, Devendra. 2014. “Managing Unwanted Fertility in India: Way Forward”, Institute of Economic Growth (ed.):   National Rural Health Mission: An Unfinished Agenda, New Delhi: Book Well. 

[4] Kothari, Devendra. 2014. “Empowering women in India: Need for a Feminist Agenda”, Journal of Health Management, 16 (2), pp 233-43. 

[5] For example, in the late seventies, it was quickly realized by the policy makers of China that with half of the population under the age of 21, further growth was inevitable even if each family was quite small. Some drastic measures are needed. The “One Child Policy” backed by quality Family planning services  was the answer to that concern and the Chinese leader Deng Xiaoping announced it in 1979 to limit China’s population growth. Such interventions were also adopted in India during seventies.  Sanjay Gandhi, a member of the Nehru-Gandhi dynasty, publicly initiated a widespread compulsory sterilization programme to limit population growth. Journalist Vinod Mehta in his 1978 book - The Sajay Story -  states that the sterilization programmes were initiated at the behest of the IMF and the World Bank. But India could not continue with the program.

[6] As per National Family Health survey-3, over all, the total wanted fertility rate of 1.9 children per woman is lower by 0.8 child (that is by 30 percent) than the total Fertility rate of 2.7. This means that if unwanted baths could be eliminated, the Total Fertility Rate would drop to below the replacement level of fertility (1.9 children per woman). 

Tuesday, 30 September 2014

Stronger Indo-U.S. ties: The need of the hour

Devendra Kothari PhD
Population and Development Analyst
Forum for Population Action

“The United States is our natural global partner.”
Prime Minister Narendra Modi

“India’s rise as a global actor can benefit the U.S.”
Senator John McCain

While India is the most populous democracy, the United States of America is the mightiest democracy in the world. It is in the interest of both to have strong ties where ever feasible. In fact, both need each other’s strategic partnership for the benefit of both their citizens and the world.    For this both countries have to think afresh keeping history behind.  And this post aims in this direction.

In last couple of months, America's Interim Ambassador Kathleen Stephens’s life in New Delhi was dominated by high profile visits from U.S. First one was of Senator John McCain, then John Kerry (Secretary of State), Penny Pritzker (Secretary of Commerce) and Chuck Hagel (Secretary of Defense). One  may say that U.S. wants to do some business deal with the new government under Prime Minister Narendra Modi and that is why it has been  showing so much interest in India and not out of any change of heart but out of necessity of US interests, especially helping American businesses.


But I think differently.  Some real changes are taking place in the American foreign policy. About two years ago, the then Secretary of State and potential presidential contenderHillary Clinton said emphatically:  “21st century belongs to Asia”. (Refer: ANI – Sat 12 Nov, 2011). “It is becoming increasingly clear that the world's strategic and economic centre of gravity will be the Asia-Pacific, from the Indian subcontinent to western shores of the Americas", noted Clinton.   Recently, Secretary of State  John Kerry reiterated the same in a policy speech delivered at the East-West Center, Honolulu on August 6, 2014. His speech focused on the next steps in the United States’ Asia-Pacific strategy.  

It appears U.S. is ready or prepared to concentrate on Asia.  In a policy statement on September 3, 2014, President Barak Obama said a major projection of US power is: “a ‘pivot’ to Asia”. According to him, close ties between the U.S. and Asia-Pacific countries are crucial for global security and economic growth. Obama's statement indicates that the western hemisphere's influence in the world is rapidly waning, and the U.S. must shift its focus from Europe to Asia to insure the “American Dream”, not “Unmaking the American Dream”, as argued by Dinesh D’Souza.[1] 

Let’s talk about the “Asia pivot”. I think Obama has learnt a lot about the changing geo-political situation in the World during his stay in the White House. The most important change in the world over the last 30 years has been rise of China. Within a few years, China’s economy will overtake America’s in size. Its armed forces, though still dwarfed by those of the United States, are growing fast in strength; in any war in East Asia, they would have home advantage. As such, an increased U.S. military presence in this part of the world will not ease or exacerbate tensions with China. As such, it is really not going to be a formidable move or option to safe guard the interest of U.S. Some experts have concluded, as noted by The Economist (August 23, 2014) that: the American “diplomacy’s task in the coming years will to find reliable partners” (p9).   I think the more formidable move could be an alliance with India.

PM Narendra Modi, in a piece for the Wall Street Journal, has laid out his agenda for the landmark five-day trip to the United States moments before he landed in New York on Friday- the September 26, 2014. He writes: “India and the U.S. have a fundamental stake in each other's success—for the sake of our values and our many shared interests. That is also the imperative of our partnership. And it will be of great value in advancing peace, security and stability in the Asia and Pacific regions; in the unfinished and urgent task of combating terrorism and extremism; and in securing our seas, cyber space and outer space, all of which now have a profound influence on our daily lives”.

India is embroiled in territorial disputes with China. The country views the growing economic and military heft of its neighbor with apprehension. And it is looking for ways to enhance its security. So when India's Prime Minister Narendra Modi and U.S. President Barak Obama gave each other a bear hug in the White House, it was tempting to read into the gesture something more than just a warm personal chemistry. Many saw it also as a strategic embrace, one aimed at promoting partnership for the benefit of both countries and the world.

Washington sees rising India as a democratic counterweight to the region’s other emerging power - china. However, only an economically strong and stable India could help America in its long-term plan. No doubt, India has the potential to become the best, even many times more than emerging economies. In a richly symbolic event, India put a spacecraft into orbit around Marrs before Modi landed in U.S., beating Japan and China in the race and doing it at a fraction of what it cost NASA. 

Still, solving the economic and social problems of a country as populous and complex as India is not easy, and what is important is that the nation finally has a leader who is willing to take on the challenge. Modi may have a tough road ahead but his disciplined style of governing and clarity of purpose could enable him to succeed. He recognizes importance of U.S. in revising the Indian economy. Since the end of the Second World War, American support/assistance has been the basis of Asian prosperity. It enabled Japan to rise from the ashes. Indeed, China’s race to prosperity could not have happened without it. Even Vietnam, America’s old foe, is clearer than ever that it wants America’s support as a resource.

During U.S. trip, PM Modi’s most important outreach was to American business. This is easy to understand given Modi's emphasis on reviving the economy. It was a message occupying front and centre when he met both Japan's Shinzo Abe and China's Xi Jinping just before the U.S. trip. This is part of his "Make in India" drive, which he lunched in a high-profile event a day before he embarked on his U.S. trip. He wrote in the Wall Street Journal: “Make in India is our commitment—and an invitation to all—to turn India into a new global manufacturing hub. We will do what it takes to make it a reality.” Here, India can certainly benefit from America’s financial resources and state of the art industrial/technological expertise to modernize its business landscape and national infrastructure; and at the same time U.S. investors can profit handsomely in the world’s most vibrant emerging market with the right foundation in place.

However, there is lot of issues to be sorted out on the ground to attract the investment. And these will be discussed in the next post to be titled:  Making “Make in India” a reality! At the same time, America has to help India to give technical support to sort out the pressing issues including developing human resources. So far the United States exercises its foreign policy through economic aid. Now time has come to follow proverb in its true sense: “Give a man a fish; you have fed him for today. Teach a man to fish; and you have fed him for a lifetime". 

I vividly remember the observation made by Myron Weiner, an American political scientist and renowned scholar on India at MIT, during one of the seminars at  the Harvard-MIT Joint Seminar on Political Development  (JOSPOD) in the early seventies; he said that  the America missed the bus  in developing close ties with India after independence   when it   was interested in the American  technical  knowledge and skill required to develop its economy especially agriculture and industries; but U.S. was keen to  export its goods. And that forced the then Prime Minister Nehru   towards USSR. Everyone including me was impressed from his frank and realistic assessment (I was one of his students). I am sure America will learn from the history.

PM Modi’s U.S. visit is successful & very enchanting. But he should not forget that Russia is our close ally. Hopefully India and USA, in becoming closer, will provide a balance in Asia, but without the adversarial approach that often accompanies such arrangements. What is not needed is an Asian arms race.




[1]For details, see:  Dinesh D’Souza’s book Obama’s America: Unmaking the American Dream, Regnery Publishing Inc., 2012.

Saturday, 16 August 2014

India debating provision of Euthanasia


Devendra Kothari Ph.D.
Population and Development Analyst,
Forum for Population Action


 To force a person to be kept alive in a vegetative state when medical opinion is as certain as can be, that there is no chance of recovery, is cruel both on the person and on his or her family and friends”.


(This post is not about my normal topics related with population and development. It is a personal exposition about something that has occupied my thoughts over the last couple of weeks. Though euthanasia is a complex issue with legal, social and religious overtones, but it must be addressed.)

Few days ago my late elder brother’s wife died due to cardiac arrest after a prolonged period of illness at the age 83. She was very close to me; and I used to visit her two to three times in a year since I live in a distant town.  For last two-year she was bed-ridden and rarely ventured out of her two-bed room apartment. She was looked after by a full-time caregiver to help her with meals, cleaning and the growing number of other tasks she could no longer do herself. But there was one thing that she refused to relinquish to her illness: that she wanted to kill herself by ingesting or injecting some painless drugs. She was not an exception. There are many Indians who wish to opt for euthanasia or assisted suicide to end their suffering. Doctors and NGOs say it could be hundreds, possibly thousands — no one knows for sure. However, killing terminally ill patients directly, even if they request it, is illegal in India. Prescribing certain barbiturates used for euthanasia in other countries is also illegal in the country.

But, the number of persons who are opting for euthanasia is going to increase sharply in coming years due to changing demographic and health scenario.[1] India’s demographic contours suggest a steep rise in the elderly population in the coming decades as a result of declining fertility, increasing expectation of life at birth and (partly) at later ages. Although the proportion of the elderly population was low in 1990, India ranked second in the world in absolute numbers in 2010, as per UN population Division. There were about 100 million elderly people in India in 2010 or one out of every ten persons was aged 60 years or more in that year. The elderly population aged 80 and above which was only 1.3 million in 1990 rose to 5.5 million in 2005 and to 9.5 million in 2010. The growth rate among different cohorts of elderly such as 60 plus, 70 plus and 80 plus during the decade 2000-2010 was much higher than the general population growth rate of 2 per cent per annum during the corresponding period. This phenomenon, coupled with rapid social changes resulting in the gradual breakdown of the traditional joint family system, is likely to pose serious problems for the elderly, especially related to their health.

Decline in morbidity and mortality from communicable diseases have been accompanied by a gradual shift to aging, and accelerated rise in the prevalence of chronic non-communicable diseases such as cardiovascular disease (CVD), diabetes, chronic obstructive pulmonary disease (COPD), cancers, mental health disorders and injuries. The occurrence of physical disabilities is another important aspect of the aging process. There were about 25 million disabled elderly persons in India in 2011, half of whom are likely to be visually disabled. Cancer is the second leading cause of death globally, taking a heavy toll of human lives and destroying the families of the cancer patients due to mental agony and heavy costs of treatment. 2/3 patients are detected in the advanced stages when treatment is ineffective. India has recorded one of the highest incidences of cancer in the world. Recently, NCRP (ICMR), Bangalore, has published a report on Time Trends in Cancer Incidence Rates. The total cancer cases are likely to go up from 979,786 cases in the year 2010 to 1,148,757 cases in the year 2020. [2]

One can visit chronic cases at hospital or even at home and give them false hope and a lecture and come back home, but one  cannot experience what they go through for the next few years till they need to live in that condition. “To force a person to be kept alive in a vegetative state when medical opinion is as certain as can be, that there is no chance of recovery, is cruel both on the person and on his or her family and friends”, as argued by the Times of India in its campaign to generate support in favor of passive euthanasia and decriminalization of attempted suicide. [3]  Recently, the Supreme Court of India recommended (on July 16, 2014)   that the question of passive euthanasia or mercy killing needs a comprehensive examination as there was no authoritative judicial pronouncement on the issue; and issued a notice to all states seeking their views on a petition on legalizing passive euthanasia or withdrawal of medical treatment with the intention of causing a patient's death.

Why only “passive euthanasia”? Why shouldn’t “active euthanasia” be permitted under law? While passive euthanasia is limited to withdrawing life support, active euthanasia goes a step further by assisting in a terminally ill patient's death (through, say, a painless injection). It is very difficult to comprehend the suffering of a person asking for death, a person lying in bed not being able to do anything himself or herself. Imagine the plight of a quadriplegic (a central character in Sanjay Leela Bhansali's film Guzaarish who cannot move anything below his neck and has his whole body paralyzed). The film concludes that he should be “granted active euthanasia on the premise that he has the right to a dignified death”. The law must, therefore, clearly allow for euthanasia — both active and passive — in such situations.[4]

Many countries in the world has recognized that it is humane to allow people to choose to die in specific situations. Switzerland, for example, allows not only its own citizens but also foreigners in certain circumstances to come to the Alpine country and seek doctors' help in ending their lives.  India itself has a tradition that sanctifies various forms of 'ichhaa mrityu' or death by choice. For example, some followers of Jainism practice Santhara. (SANTHARA is a religious Jain fast. Under this, a person goes on infinite fast, till eventually death comes.)

If we accept that somebody can consciously choose to die, there is nothing wrong about an informed decision being made for that person in his best interests, when he is in a persistent vegetative state. In actual practice, many families have had to take the painful decision to withdraw life support systems, either because they wish to end the patient's suffering or simply because they can no longer afford it. The Supreme Court has in the past acknowledged that the right to dignity in life also extends to the right to a dignified death, though that ruling applied this principle only to 'natural death'. It is time now to extend it further and adjust the law to the reality and to a more modern moral sensibility by allowing people to choose to die peacefully. There must, however, be very strict safeguards to ensure that the provision is not misused by people, who may benefit from the death of the patient. Further, we must offer the patient seeking euthanasia a variety of alternatives, including palliative or hospice care, pain management through medication and other therapies. But if, after everything, they still choose help in killing themselves, then their wishes must be respected.

In short, the issue in question is very sensitive but extremely important to address at. Euthanasia is a much awaited legal option and does much good for the suffering millions without hope of a cure. It is already available in some other advanced nations which shows that it is the only logical conclusion in certain cases of human suffering. It is long pending issue in India. Further calling debate means pushing the issue back.




[1] Sandip Kumar and Amit Kaushik. Non-communicable Diseases: A Challenge, Indian Journal of Community Health, Vol. 24 (4), 2012; H.B. Chanana and P.P. Talwar. Aging in India: its Socioeconomic and Health Implications, Asia-Pacific Population Journal, Vol. 2 (3).

[2] Takiar R, Nadayil D, Nandakumar A. Projections of number of cancer cases in India (2010-2020) by cancer groups. , Asian Pac J Cancer Prev. 2010; 11(4), 2010.

[3] The Times of India, has in the past, campaigned in favor of passive euthanasia and decriminalization of attempted suicide.  For details, see at: www.toi.in/endtrauma.

[4]For details, see at: www.toi.in/endtrauma.